Individual
JAMES T BOWLUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
610 E KIRACOFE AVE, ELIDA, OH 45807-1034
(419) 331-0443
(419) 331-3137
Mailing address
PO BOX 3097, ELIDA, OH 45807-0097
(419) 331-0443
(419) 331-3137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35036062
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000355251
ANTHEM BC BS
OH
01
—
012675073
RAILROAD MEDICARE
OH
05
—
0305146
—
OH
01
—
341435892-00
WORKER'S COMPENSATION
OH
Enumeration date
02/13/2006
Last updated
08/03/2023
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